European Journal of Cancer: Highlights of Issue 38:03

A current perspective of adjuvant treatment design for premenopausal breast cancer patients

In their Current Perspective, Jakesz and colleagues discuss the role of adjuvant chemotherapy and hormonal therapy for the treatment of premenopausal breast cancer patients. The authors examine recent data comparing chemotherapy versus ovarian oblation, versus tamoxifen, versus luteinising hormone-releasing hormone (LHRH) analogues and versus LHRH analogues and tamoxifen. They conclude that “various endocrine treatment modalities have been substantiated as equiefficient to polychemotherapy” and that “the selection of adjuvant systemic therapy for premenopausal breast cancer patients should be increasingly guided by knowledge of the steroid hormone receptor levels”.

Patients prefer oral UFT/LV to intravenous FU/LV

Oral regimens have the advantages of convenience, reduced costs and are also often associated with reduced toxicity when compared with intravenous (i.v.) administrations. In this issue, Borner and colleagues examine using a prospective, randomised crossover trial, patients’ preference for either an oral adminstration of UFT/leucovorin (LV) (300mg/m²/day UFT and 90mg/day LV for 28 days) or i.v. 5-fluorouracil (FU) and LV (20mg/m²/day LV followed by 425mg/m²/day FU for 5 days). Patients received both treatment options and then were asked their preference. A questionnaire before and after treatment was used to assess their preferences. Interestingly, before treatment, patients were most concerned about the possible side-effects of treatment, whereas after the treatment, the mode of administration became more important. 84% of the evaluable patients preferred the oral treatment, possibly in part due to the increased toxicity (stomatitis and haematological) seen with the i.v. regimen.

Do corresponding subscales of Quality Of Life instruments measure similar aspects?

In this issue Kuenstner and colleagues investigate this question using questionnaires received from 234 cancer patients. The questionnaires were sent in two waves; the first set comparing the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) and SF-36 Quality of Life (QoL) instruments and the second set comparing the EORTC QLQ-C30 and the Functional Living Index Cancer (FLIC) QoL instruments. Seven dimensions were assessed using a multi-trait, multi-method analysis. In 5 of these 7 dimensions, (physical functioning, emotional functioning, pain, fatigue/vitality and nausea and vomiting) convergent validity exceeded the corresponding correlations of discriminant validity. This infers that for these subscales the three instruments are measuring similar aspects of the patient’s quality of life. In contrast, the data suggested that the overall health and social functioning subscales of the different instruments can not be equated.

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